Paroxetine, a new, potent and selective serotonin (5-HT) uptake inhibitor has been evaluated in an open study for its clinical effect as well as its effect on the 5-HT concentration in whole blood in 19 patients with depressive illness. Paroxetine was administered in daily doses of 20 to 60 mg. The global evaluation after six to eight weeks showed a marked improvement in 11 patients, a moderate improvement in four and no change in four patients. Assessment with the Hamilton Rating Scale for Depression in ten patients showed a reduction from a mean score of 22.7 to 6.6 in six weeks. Maximal reduction was, however, first seen in three of the patients after 8 to 12 weeks. No correlation between the antidepressant effect and plasma concentrations of paroxetine was found. The only side effects noted with paroxetine were that two patients complained of dry mouth in the beginning of the treatment and a further patient experienced a burning sensation together with periodical light headache. Generally laboratory examinations did not show any trend towards pathological values except in one patient, where a moderate leucopenia was observed. Crista puncture/biopsy showed, however, no specific bone marrow reaction. The 5-HT concentration in whole blood was reduced to about 0.02 micrograms/ml indicating a total depletion of 5-HT from the thrombocytes. The present study indicates that paroxetine possesses a good antidepressive effect in combination with a very low frequency of side effects.
term Antabuse treatment: tolerance and reasons for withdrawal. Acta Psychiatr Scand 1992: 86: 47-49.Abstract -We studied 210 alcoholics, who were re-admitted to a disulfiram treatment programme after having voluntarily discontinued disulfiram therapy, primarily to ascertain whether illness, hospitalization, or serious adverse effects were the cause of the withdrawal. A simple 9-item questionnaire was used. About 70 'To of the patients gave either "a wish to drink again" or "no need for further treatment" as the reason. Withdrawal in the remaining patients was in no case related to adverse effects of disulfiram.The low incidence of adverse effects was confirmed in another group comprising 93 patients treated under supervision with disulfiram 600-800 rng twice a week for at least a year (i.e. total dose at least 70 g disulfiram). They were monitored by standard laboratory blood and urine tests. There were no clinically significant changes in the measures used. Indeed, many of the patients improved during the year of abstinence. These two studies add weight to the evidence that disulfiram is not a drug with a high incidence of adverse
Femoxetine, a phenylpiperidine derivative with potent serotonin (5-HT)-uptake inhibitory properties, was investigated in 12 depressive patients for its clinical effect as well as its effect on 5-HT concentration in whole blood. The global evaluation after 6 weeks showed a good effect in six patients. The 5-HT concentration was found to be reduced from a mean value of 0.21 to about 0.05 micrograms/ml, indicating a total depletion of 5-HT from the thrombocytes. The steady-state concentrations of femoxetine resulted in reduction of 5-HT to the same level in all patients. No correlation between degree of 5-HT reduction and therapeutic effect was found.
SummaryThis uncontrolled study presents 188 patients primarily diagnosed as addictive alcoholics and fulfilling the DSM III diagnostic criteria for panic disorder or major depression, 104 and 84 patients, respectively. The study focused on clinical outcome of pharmacological intervention with combined fluoxetine and disulfiram treatment. The patients were followed for (up to) 40 months. A good clinical outcome for both groups was found in 70%. In a subgroup of 37 patients ‘quality of life’ was assessed using quality of life scales. An appropriate correlation emerged between clinical judgement of outcome and the patients’ self-rating. Although the study was limited by being uncontrolled, the results have shown, that specific treatment in a group of alcoholics with comorbid psychopathology within the anxiety and depression spectrum is possible even after many years of addictive alcohol abuse. The necessity for proper psychiatric assessment is stressed.
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